“NEW KIDNEY, NEW LIFE” – Doctor-Patient Trust Brings
Joy to Many
By Bryan Adrian for Georgia Today
Bryan Adrian for GEORGIA TODAY
The current President of Georgia, Michael Saakashvili started the Rose Revolution in late 2003, and since 2011 on the 8th floor of Tbilisi’s new High Technology Medical Center University Clinic, in the Department of Renal Replacement Therapy and Nephrology, under the guidance of Dr. Irma Tchokhonelidze, a new revolution in medical practices in kidney healthcare, dialysis, and kidney transplantation, has gone into full swing in the struggling Republic of Georgia.
Dr. Tchokhonelidze’s philosophy leans heavily towards the doctor-patient trust relationship and she relies on her hand picked staff to carry out her vision.
Just two weeks ago, on Dr. Tchokhonelidze’s 8th floor in the High Technology Medical Center next door to the old “Aramiantsi clinic”, ten patients were being prepped for their transplant operations, each of them expectant of their “new kidney, new life,” thanks to the generous and precise master surgery of visiting Dr. Jan Schmidt, who flew in from Switzerland on the invitation of his professional colleague here in Tbilisi, Dr. Irma Tchokhonelidze. She had invited him for the third time in two years to come to Georgia and decrease the numbers of her patients with chronic kidney disease, those patients who otherwise would have to be attached for the remainder of their lives to a dialysis machine, all 50 of them running day and night in three shifts in her large nephrology clinic. How can this national Georgian dialysis patient-load be decreased, she asked herself? The magic and beauty of a kidney transplant is that with just one kidney transplanted into a diseased patient, it can free that patient forever from the grip of a hemodialysis machine. After a transplant, a patient needs only to take immuno-suppression pills for the rest of their years, effectively living a normal life, like everyday people with healthy kidneys. This is a very huge reward for the patient, who suddenly has no more need for dialysis whatsoever.
A transplant requires a lot of “patient-trust” in the doctor, a confidence known worldwide as a positive “doctor-patient trust relationship”. A transplant needs a lot of trust not only within the patient towards their transplant surgeon, but also lots of patient trust invested in the entire renal replacement nephrology department. Successful transplants incorporate many variables, such as sterilized hemodialysis machines, free of AIDS and hepatitis B and C, and spotlessly clean surgical tools and equipment. All this must be combined with an almost religious faith and trust in the expertise and experience of the surgeon. It is a team effort in which everyone plays an important part, both large and small.
Dr. Jan Schmidt has already performed over
12,000 operations in his long career, 900 of them transplants of different
organs. His career stretches from
Dr. Schmidt often does three transplants
per day when in
The ever modest Dr. Schmidt, despite his
status and recognition as one of the leading transplant and abdominal surgeons
in the world, told Georgia Today newspaper, “My philosophy is, always learn to do
one thing well in your life, and for me, that one thing is surgery. I don’t do many other things so well …. I
want to add, that surgery is what I most absolutely like to do in life.” He credited Dr. Tchokhonelidze in his next
breath, “Please promote Dr. Irma, not me, she is the mastermind of this
transplant arrangement and I am just her servant.” Dr. Jan concentrates on teaching his special medical
skills, nearly as much as performing his successful surgical operations. His surgery and procedures are open to
Georgian surgeons for observation while he is in
Dr. Tchokhonelidze has an efficient staff of 6 female nephrologist physicians, all near the age of 30, and one male nephrologist, who is a contemporary of Dr. Tchokhonelidze. They all focus on the flawless administration of immuno-suppressant therapy during both pre-op and post-op transplant operations. Dr. Irma trained most of them in the newest methods and techniques gleaned from European and American and world nephrology medical journals, and from many internal medicine and nephrology lectures presented at several global congresses. Her whole team’s aim is to advance their clinic to the levels of European standards, as quickly as possible, albeit not too hastily either.
The owner and director of this entire HTMC
hospital complex, Dr. George Ingorokva, since first opening the doors of his
new hospital clinic facilities in 2009, has done an impressive job of providing
the newest and best medical equipment possible, in a former CIS nation. This modern-equipped full medical facility is
among the finest hospital complexes in the country of
Dr. Irma is hoping that the number of kidney transplants increases over the coming years, so as to free up the dialysis machines for more new and needy dialysis patients. She says, “Since 1997 the Government of Georgia has paid for kidney transplants from living donors who are related to the recipients. Before 2011, treatment of renal failure by dialysis was free for only a limited number, those lucky ones who fit into the restrictions of the federal budget, so some diseased patients who had to pay out-of-pocket, were left to die prematurely. Thank god, the government decreed in May 2011, just one month before I opened this new dialysis clinic, that all patients with chronic renal failure would receive free dialysis treatment. We no longer had to deny treatment for non-payment. It had been a torture during our long earlier era of dialysis, to abandon those without sufficient money and who the budget ignored.”
Dr. Irma says that she is very grateful
that Dr. Jan has come as often as he has to
“We need to expose our physicians to
Western European and American methods and techniques and standards, as quickly
as possible,” she insists. “Dr. Jan will
train one of our surgeons in his techniques the next time he visits
Meanwhile, the young female doctors on Dr.
Irma’s staff are radiant with hope for the future of medicine in
Dr. Nora Sarishvili on Dr. Irma’s team said
“Dr. Jan is very glamorous in his surgical technique. I want to go abroad to
At a dinner party in honor of Dr. Jan,
thrown by ten elated former recipients of kidneys here in Tbilisi, transplanted
under the scalpel of Dr. Jan’s earlier surgical visits, along with these ten
grateful recipients were many of the donors of those same kidneys. Enjoying his dinner with them all was a very
thankful young man named Tsotne, 22 years old, who earned his masters degree in
“I went to
Among the appreciative kidney recipients at the 2013 farewell party for Dr. Jan, were an attractive blind girl in her 20s, with her mother. In addition, there was a young 15 year old boy with his father, who had donated his kidney a year ago to his son, and a sister who had donated a kidney to her brother. All were with irrepressible smiles on their faces, and they could not slow down their enthusiastic praises for Dr. Jan’s skillful talents.
Dr. Irma is hoping this cross-cultural program continues into the near and distant future, and that transplantation receives more funding from the Georgian government, and with more luck, from concerned investors also.
NON FICTION by Bryan
FICTION by Bryan Adrian